WASHINGTON – In a far-reaching, freewheeling 90-minute acceptance speech for the Republican nomination for president, former President Trump listed the populist highlights: Americans will have faster access to new medicines, real answers for cancer and Alzheimer’s disease, and better Medicare in his second term, he claimed.
But aside from a passing comment about women’s sports, Trump steered clear of a growing effort by Republican lawmakers to restrict the rights of transgender people and ban gender-affirming care. He also made no mention of abortion, a reflection of his campaign’s efforts to distance Trump from increasingly unpopular bans alienated voters in key states.
Restricting access to abortion and health care for transgender people are two major policy priorities that made them a relatively sparse 16-page platform from the Republican National Committee this month. While the party is actually turning away from the hard line for a federal abortion ban, it has focused on transgender people, roughly 1% of the American population, which is central to the anger of Republican voters.
The shift came as Trump and other Republicans saw broad voter opposition to interference in reproductive care, LGBTQ advocates say. As Trump, his Vice President J.D. Vance, and other party members softened their positions on abortion policy, they stepped up attacks on another health care avenue and promised federal bans on gender-affirming surgeries and treatments.
“They started throwing spaghetti at the wall to figure out where they could go. And unfortunately what stuck was transgender youth,” said Lanae Erickson, senior vice president for social policy, education and politics at Third Way, a center-left think tank.
Gender-affirming care for minors has galvanized the conservative base and launched hundreds of bills in mostly red states that seek to outright ban this care, limit youth sports participation, and ban taxpayer funding of any procedure or care.
Yet national-level polls suggest that moderate and independent support for gender-affirming care has actually grown in recent years. Among independent voters, 56% were against criminalizing gender-affirming care for minors March 2023 NPR/PBS/Marist Pollcompared to 45% who opposed a ban NPR/Ipsos poll from June last year. Republican opposition to gender-affirming care for minors grew during that time, while Democratic support held steady at just under 70%.
The polls parallel voters’ responses on abortion policy: 63% of Americans believe abortion should be legal in “all or most cases,” according to a May 2024 poll from Pew Research Center.
The rights of transgender people represent another thorny area of health care freedom that Republicans can step into as voters respond to state bans. Most Ohioans, for example don’t like candidates who are champions restrictions on gender-affirming care. A federal court in the state this week challenges heard to a law banning gender confirmation surgery and medications such as hormone therapy.
The Supreme Court recently agreed to hear a case over Tennessee’s ban on gender-affirming care for minors, promising arguments as early as this fall on how far lawmakers can go to restrict health care.
Trump hits the high points
Trump stuck to the highlights of his presidency Thursday evening, touting a law aimed at giving patients quick access to experimental therapies and promising to strengthen Medicare. While the vast majority of his hour-and-a-half speech updated conference attendees on the economy, border control and foreign relations, the former president touched on health care issues such as the Right to Try legislation that are polling well with pollsters. voters, even if they have seen little impact so far.
‘They’ve been trying to get that approved for 52 years. That wasn’t that easy,” Trump said of the Right to Try Act, aimed at expanding terminally ill patients’ access to therapies still in the development pipeline. “What’s happened is we’re saving thousands and thousands of lives. It’s unbelievable.”
The Food and Drug Administration already has a compassionate use pathway for patients to appeal the use of not-yet-approved medications, and has approved thousands of uses over the years. But there were justifications under the Right to Trial Act four applications in the past financial year.
The former president also denounced President Biden’s efforts to find cancer cures through the multibillion-dollar Cancer Moonshot project and criticized the Democrat’s failure to make progress on Alzheimer’s disease.
“This man said we’re going to find the cure for cancer. Nothing happened. We’re going to find the cure for cancer, Alzheimer’s disease and so many other things,” Trump said. “We are so close to something big, but we need a leader to make it happen.”
The fight for transgender rights
It was immediately after Trump’s comments about cancer and Alzheimer’s disease that he made his only passing mention of the brewing battle over transgender rights, promising that “we will no longer let men play in women’s sports, that will end come.”
The comment ignored what both the party and its Vice President Vance have advocated to effectively end certain forms of gender-affirming care, regardless of the person’s age.
The RNC platform states that the party will “ban taxpayer funding of gender reassignment surgery and prevent taxpayer-funded schools from promoting gender transition.”
In addition to blocking Medicaid and Medicare funding for such procedures, Republicans could institute laws that would bar any CMS-funded hospital that practices gender-affirming care.
Louisiana passed legislation last year blocking gender-affirming care for minors; then the state’s Department of Health released a report showing that between 2017 and 2021, fewer than ten minors in the state were prescribed gender-affirming medications such as puberty blockers. The state recorded no cases of a minor undergoing gender-affirming surgery at that time.
“It’s an exceptionally cruel policy looking for a problem,” said Kellan Baker, executive director of the Whitman-Walker Institute, a medical nonprofit focused on LGBTQ health care.
Limits on transgender rights and health care quickly became a Republican lightning rod in the so-called culture wars with the left. The word “gender” appears nowhere in the Republican National Committee’s 2016 platform, which reissued it in 2020. By comparison, the Democratic National Committee’s 2020 platform mentions the word fifteen times, usually in the context of equality or anti-discrimination protections. but also twice in the context of protecting the welfare of trans and non-binary children.
Republican lawmakers are well aware that broad limits on transgender rights and health care do not resonate widely. That of North Carolina so-called bathroom bill in 2016, which would have barred people from using facilities that aligned with their gender identity, was met with corporate boycotts and national criticism. But the shift in recent years to focus on minors’ health care choices has rallied not only conservative voters but also concerned parents, advocates say.
“The Democrats felt like they had won on that issue,” Erickson said in North Carolina. “But then we’ve now turned to young people, and that’s where voters think things are a lot more complicated.”